antidiabetic agents

Question 1

Name the rapid-acting insulins

Answer 1

• Insulin Lispro
• Insulin Aspart
• Insulin Glulisine

Question 2

Name the short-acting insulins

Answer 2

• regular insulin

Question 3

Name the intermediate-acting insulins

Answer 3

• NPH
• Isophane insulin

Question 4

Name the long-acting insulins

Answer 4

• insulin glargine
• insulin detemir
• insulin degludec

Question 5

tx of type I DM

Answer 5

exogenous insulin must be injected

Question 6

classical symptoms of diabetes mellitus

Answer 6

• polyuria
• polyphagia
• polydipsia

Question 7

What are the various means of diagnosis diabetes mellitus

Answer 7

1. fasting (overnight): venous plasma glucose concentration > 126 mg/dl on at least 2 seperate occasions
2. following ingestion of 75 g of glucose: venous plasma glucose concentration > 200 at 2 hr and on at least one other occasion during the 2 hr test

Question 8

what is hemoglobin A1C

Answer 8

• a glycosylated protein
• proportional to long term blood glucose concentration

Question 9

normal, poorly controlled DM, and desirable level for hemoglobin A1C

Answer 9

• normal < 6%
• poorly controlled > 10%
• desirable level for tightly controlled diabetes < 7%

Question 10

what is C peptide level used to measure

Answer 10

• C peptide and insulin made in 1:1 ratio. measurement for insulin production in pancreas

Question 11

insulin release is activated by

Answer 11

• glucose
• beta 2 adrenergic agonists

Question 12

insulin release is inhibited by

Answer 12

alpha 2 agonists

Question 13

insulin promotes entry of glucose into

Answer 13

• skeletal muscle
• heart muscle
• fat tissue
• leukocytes
• **not required for glucose transport into brain, liver and RBC

Question 14

actions of insulin on liver

Answer 14

• decreases gluconeogenesis
• increases glycogen synthesis

Question 15

actions of insulin on muscle and adipose tissue

Answer 15

stimulates glucose uptake via GLUT 4 transporter

Question 16

higher Km and glucose transport

Answer 16

• higher Km = needs higher concentration for transporter to transport glucose

Question 17

how is insulin metabolized

Answer 17

• liver and kidney remove insulin from the systemic circulation by hydrolysis of disulfide connections

Question 18

adverse effects of insulin

Answer 18

• hypoglycemia
  
  • signs and symptoms dissapear after repeated events

Question 19

treatment of hypoglycemia

Answer 19

• give 50-100 ml of 50% glucose solution IV
• 0.5-1 mg glucagon injection

Question 20

how is insulin given? which are okay to give IV

Answer 20

• SQ
• rapid and short acting insulins
  
  • okay for IV

Question 21

differentiate between injections and pump

Answer 21

• injections: create an insulin profile and eat to fill it
• pump: adjust insulin boluses according to what you eat

Question 22

glucagon produced by what cells

Answer 22

alpha cells of pancreas

Question 23

MOA of glucagon

Answer 23

• increase blood glucose levels by mobilizing hepatic glycogen when available

Question 24

how is glucagon administered? onset of action

Answer 24

• parenterally
• onset of action: gradual

Question 25

MOA of diazoxide

Answer 25

• non-diuretic thiazide that directly inhibits insulin secretion

Question 26

use of diazoxide

Answer 26

• used in patients with insulinoma
  
  • ​insulin producing tumor

Question 27

MOA of Sulfonylureas

Answer 27

• stimulate insulin release from pancreatic B cells by binding to K+ receptors

Question 28

adverse effects of Sulfonylureas

Answer 28

• hypoglycemia
• weight gain

Question 29

contraindications to Sulfonylureas

Answer 29

• allergies to sulfa drugs
• severe renal disease or hepatic dysfunction

Question 30

List the Sulfonylureas

Answer 30

1. Tolbutamide
2. Chlorpropamide
3. Tolazamide
4. Glyburide
5. Glipizide
6. Glimiperide

Question 31

MOA of Sulfonylureas drugs

Answer 31

 Binding to and blocking ATP-sensitive K+ channel to cause membrane depolarization and increase Ca2+ influx on B cells.